Ms Kibasa Samuel, LCSW, CASAC, SAP MAC is a
Social Worker - Clinical based in Commack, New York. Ms Kibasa Samuel is licensed to practice in New York (license number 090232) and her current practice location is
169 Commack Rd # 1010, Commack, New York. She can be reached at her office (for appointments etc.) via phone at
(516) 430-7372.
NPI number for Ms Kibasa Samuel is 1407227879 and her current mailing address is 169 Commack Rd # 1010, Commack, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1407227879.
Healthcare Provider's Profile
| Full Name | Ms Kibasa Samuel |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 169 Commack Rd # 1010, Commack, New York |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1407227879
- Provider Enumeration Date: 10/12/2015
- Last Update Date: 02/23/2022
Medical Identifiers
Medical identifiers for Ms Kibasa Samuel such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407227879 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 31589 (New York) | Secondary |
| 101YP2500X | Counselor - Professional | 4937560 (New York) | Secondary |
| 104100000X | Social Worker | 72091813 (New York) | Secondary |
| 1041C0700X | Social Worker - Clinical | 090232 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Kibasa Samuel is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Kibasa Samuel, LCSW, CASAC, SAP MAC
169 Commack Rd # 1010,
Commack, NY 11725-3442
Ph: (516) 430-7372 | Ms Kibasa Samuel, LCSW, CASAC, SAP MAC
169 Commack Rd # 1010,
Commack, NY 11725-3442
Ph: (516) 430-7372 |
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